More Information

State expects big turnout for Affordable Care Act rollout

Bev Veals undergoes chemotherapy treatment at Duke Cancer Center in Durham. Coping with advanced cancer, Veals was in the hospital for chemo this summer when she got a call that her health plan was shutting down. Then, the substitute coverage she was offered wanted $3,125, on top of premiums. Photo by Associated Press

Published: Saturday, September 28, 2013 at 8:30 p.m.

Last Modified: Friday, September 27, 2013 at 11:12 p.m.

Socal social services agencies say they expect to see an influx of people at their doorstep in the coming days as residents seek information about the subsidized insurance marketplace under the Affordable Care Act.

Facts

By the numbers

Uninsured: According to U.S. Census estimates for 2012 for counties with populations of at least 65,000:In New Hanover County, 31,084 (15.1 percent) of the total 206,497 population was uninsured. In Brunswick County, 18,025 (16.2 percent) of the total 111,087 population was uninsured.Sneak peek: The Kaiser Family Foundation provides an online calculator to estimate your insurance plan cost. Go to http://kff.org/interactive/subsidy-calculator/

Looking for help?N.C. Insurance Advisors, a local insurance agency, is hosting a series of informational seminars in tandem with Blue Cross Blue Shield of North Carolina about the new federal health insurance program. The meetings, which are free, are aimed at both individuals and businesses.Thursday: 6-8 p.m. at the Small Business Center at Cape Fear Community College. Pre-register, which is required, at www.cfcc.edu/sbc. (Specifically for small businesses)Oct. 8: 10-11 a.m. at Northeast library, 1241 Military Cutoff Road.Oct. 9: 3-4 p.m. at Northeast library.Oct. 15: 10-11 a.m. at New Hanover County Cooperative Extension, 6206 Oleander Drive.Oct. 26: 10-11 a.m. at county Cooperative Extension.Oct. 29: 6:30-7:30 p.m. at county Cooperative Extension.

The open-enrollment period for the health insurance overhaul, also known as Obamacare, begins Tuesday. As many as 1.5 million people in North Carolina will be shopping for health insurance, the state estimates.

"The state is calling it the woodwork effect; people will be coming out of the woodwork," said Christine McNamee, assistant director in charge of economic services for New Hanover County Department of Social Services. "They're going to be hoping they're eligible for Medicaid. So we do anticipate more people coming in Oct. 1."

The state opted not to expand Medicaid under the Affordable Care Act to some half-million people. Still, state estimates project roughly 70,000 new people may enroll in Medicaid because of the new law's mandate that everyone have health coverage by Jan. 1, according to a report by the N.C. Institute of Medicine. These are individuals who are eligible for Medicaid but for whatever reason are not enrolled.

Low- and moderate-income families, with incomes between 100 percent to 400 percent of the federal poverty level, will be eligible for subsidies to help them purchase health insurance coverage in the newly created health insurance marketplaces. The "exchanges" and Medicaid are required to use the same application form. Thus, when a person applies for private coverage in the exchange, he or she is also applying for Medicaid; eligibility will be determined based on income, the institute explains in a brief.

When people visit the local social services agency, "If they're not eligible (for Medicaid) we would do a streamlined application to see if they may be eligible for the Affordable Care Act," McNamee added. "We would share that with the federally facilitated marketplace."

She noted that people also can go directly to healthcare.gov and do their own application.

Feds: N.C. better than expected

In North Carolina, Blue Cross and Blue Shield and Coventry Health Care of the Carolinas, will sell subsidized plans.

But Coventry is not statewide, and it won't offer plans to individuals in New Hanover, Pender or Brunswick counties.

Though only two insurers are offering plans in the state, the federal government issued a press release last week saying North Carolina consumers will have more options than expected – an average of 22 plans in the marketplace.

"We are excited to see that rates in the 'North Carolina Marketplace' are even lower than originally projected," Health and Human Services Secretary Kathleen Sebelius said in a statement.

Still, North Carolina residents will pay more than the national average and have fewer choices on the state's federally run online marketplace than people in other states, according to figures released Wednesday by federal health officials.

Average premiums in North Carolina for a mid-range health insurance plan will be $369 a month before tax breaks are applied, according to federal figures. The average monthly cost for mid-range coverage across 48 states will be $328. Those are the estimated prices before any tax breaks are applied.

State encourages navigators

North Carolina has not embraced Obamacare. It turned down Medicaid expansion, opted not to create its own exchange program, and declined some $27 million in federal assistance for promotion activities.

But North Carolina is encouraging county social services departments to provide office space for "navigators," workers paid for by federal grant funds to help individuals navigate the new insurance-buying process. Some states are putting up roadblocks to navigators in the field.

"We encourage all social service agencies to allow navigators to work onsite if your facility can accommodate them," Wayne Black, director of the state division of social services, said in a Sept. 18 letter. "This will provide valuable assistance to those who are interested in purchasing a plan through the federal exchange."

DHHS spokesman Ricky Diaz said it was the "right thing to do" given the "confusion and lack of information" about the federal health care law.

Because the state turned down taking on a promotional role, hospitals, nonprofits and local agencies are stepping in.

There are four entities in the state with grant funds to serve as navigators of the new health care marketplace. They are: Randolph Hospital, Mountain Projects, Alcohol Drug Council of NC and N.C. Community Care Networks, which plans to farm the work out to local entities.

Too little, too late?

N.C. Department of Health and Human Services also passed along several information fliers to county social services agencies about the exchange program and Medicaid eligibility.

But one group is calling the state's efforts too little, too late.

Candice Davies is director of the North Carolina chapter of Protect Your Care, a D.C.-based nonprofit whose mission is to provide information to residents about the Affordable Care Act. The group is in 11 states, including North Carolina.

"In the last week or two we're starting to see some information, but this has been a law for years, this has been coming for years," Davies said. "We feel like people should have been informed about this a long time ago."

Reta Shiver is frustrated too. As director of the Pender County Department of Social Services, she's concerned with the extra workload that will be placed on her staff. She requested additional positions from the county but was denied.

"Everything at this point is speculation," she said of how busy the agency may become. "I know it's going to impact the agency very seriously, and I have been trying to discuss it with officials in Pender County and it's not being received very well."

"I'd rather not say more," she added.

It's unclear whether every county social service agency will include a navigator to help people understand the complicated law. In Pender, for instance, Shiver said, "We've been trying to reach out to see if there are some (navigators) we can borrow, but we've not had success at this point."

In New Hanover, Med North, formerly New Hanover Community Health Center, has employed an outreach and enrollment specialist who will help people navigate the Affordable Care Act website, healthcare.gov, and choose the best available insurance policy for them. The specialist will be at the Department of Social Services, 1650 Greenfield St., on Tuesdays, beginning Oct. 8.

The state, though, is largely taking a hands-off approach.

Kerry Hall, spokeswoman for the Department of Insurance, said it's really "up to the federal government" to promote the exchange information. Still, she said, the agency expects to get phone calls and will be as helpful as possible.

"We're going to provide as much assistance as we can within our realm of authority and within the resources we have available," Hall said.

N.C. Insurance Advisors, a local insurance agency, is hosting a series of informational seminars in tandem with Blue Cross Blue Shield of North Carolina about the new federal health insurance program. The meetings, which are free, are aimed at both individuals and businesses.

Thursday: 6-8 p.m. at the Small Business Center at Cape Fear Community College. Pre-register, which is required, at www.cfcc.edu/sbc. (Specifically for small businesses)

<p>Socal social services agencies say they expect to see an influx of people at their doorstep in the coming days as residents seek information about the subsidized insurance marketplace under the Affordable Care Act.</p><p>The open-enrollment period for the health insurance overhaul, also known as Obamacare, begins Tuesday. As many as 1.5 million people in North Carolina will be shopping for health insurance, the state estimates.</p><p>"The state is calling it the woodwork effect; people will be coming out of the woodwork," said Christine McNamee, assistant director in charge of economic services for New Hanover County Department of Social Services. "They're going to be hoping they're eligible for Medicaid. So we do anticipate more people coming in Oct. 1."</p><p>The state opted not to expand Medicaid under the Affordable Care Act to some half-million people. Still, state estimates project roughly 70,000 new people may enroll in Medicaid because of the new law's mandate that everyone have health coverage by Jan. 1, according to a report by the N.C. Institute of Medicine. These are individuals who are eligible for Medicaid but for whatever reason are not enrolled. </p><p>Low- and moderate-income families, with incomes between 100 percent to 400 percent of the federal poverty level, will be eligible for subsidies to help them purchase health insurance coverage in the newly created health insurance marketplaces. The "exchanges" and Medicaid are required to use the same application form. Thus, when a person applies for private coverage in the exchange, he or she is also applying for Medicaid; eligibility will be determined based on income, the institute explains in a brief.</p><p>When people visit the local social services agency, "If they're not eligible (for Medicaid) we would do a streamlined application to see if they may be eligible for the Affordable Care Act," McNamee added. "We would share that with the federally facilitated marketplace."</p><p>She noted that people also can go directly to healthcare.gov and do their own application.</p><h3>Feds: N.C. better than expected</h3>
<p>In North Carolina, Blue Cross and Blue Shield and Coventry Health Care of the Carolinas, will sell subsidized plans.</p><p>But Coventry is not statewide, and it won't offer plans to individuals in New Hanover, Pender or Brunswick counties. </p><p>Though only two insurers are offering plans in the state, the federal government issued a press release last week saying North Carolina consumers will have more options than expected – an average of 22 plans in the marketplace. </p><p>"We are excited to see that rates in the 'North Carolina Marketplace' are even lower than originally projected," Health and Human Services Secretary Kathleen Sebelius said in a statement. </p><p>Still, North Carolina residents will pay more than the national average and have fewer choices on the state's federally run online marketplace than people in other states, according to figures released Wednesday by federal health officials.</p><p>Average premiums in North Carolina for a mid-range health insurance plan will be $369 a month before tax breaks are applied, according to federal figures. The average monthly cost for mid-range coverage across 48 states will be $328. Those are the estimated prices before any tax breaks are applied.</p><h3>State encourages navigators</h3>
<p>North Carolina has not embraced Obamacare. It turned down Medicaid expansion, opted not to create its own exchange program, and declined some $27 million in federal assistance for promotion activities. </p><p>But North Carolina is encouraging county social services departments to provide office space for "navigators," workers paid for by federal grant funds to help individuals navigate the new insurance-buying process. Some states are putting up roadblocks to navigators in the field.</p><p>"We encourage all social service agencies to allow navigators to work onsite if your facility can accommodate them," Wayne Black, director of the state division of social services, said in a Sept. 18 letter. "This will provide valuable assistance to those who are interested in purchasing a plan through the federal exchange." </p><p>DHHS spokesman Ricky Diaz said it was the "right thing to do" given the "confusion and lack of information" about the federal health care law. </p><p>Because the state turned down taking on a promotional role, hospitals, nonprofits and local agencies are stepping in. </p><p>There are four entities in the state with grant funds to serve as navigators of the new health care marketplace. They are: Randolph Hospital, Mountain Projects, Alcohol Drug Council of NC and N.C. Community Care Networks, which plans to farm the work out to local entities.</p><h3>Too little, too late?</h3>
<p>N.C. Department of Health and Human Services also passed along several information fliers to county social services agencies about the exchange program and Medicaid eligibility. </p><p>But one group is calling the state's efforts too little, too late. </p><p>Candice Davies is director of the North Carolina chapter of Protect Your Care, a D.C.-based nonprofit whose mission is to provide information to residents about the Affordable Care Act. The group is in 11 states, including North Carolina. </p><p>"In the last week or two we're starting to see some information, but this has been a law for years, this has been coming for years," Davies said. "We feel like people should have been informed about this a long time ago." </p><p>Reta Shiver is frustrated too. As director of the Pender County Department of Social Services, she's concerned with the extra workload that will be placed on her staff. She requested additional positions from the county but was denied. </p><p>"Everything at this point is speculation," she said of how busy the agency may become. "I know it's going to impact the agency very seriously, and I have been trying to discuss it with officials in Pender County and it's not being received very well." </p><p>"I'd rather not say more," she added. </p><p>It's unclear whether every county social service agency will include a navigator to help people understand the complicated law. In Pender, for instance, Shiver said, "We've been trying to reach out to see if there are some (navigators) we can borrow, but we've not had success at this point." </p><p>In New Hanover, Med North, formerly New Hanover Community Health Center, has employed an outreach and enrollment specialist who will help people navigate the Affordable Care Act website, healthcare.gov, and choose the best available insurance policy for them. The specialist will be at the Department of Social Services, 1650 Greenfield St., on Tuesdays, beginning Oct. 8.</p><p>The state, though, is largely taking a hands-off approach. </p><p>Kerry Hall, spokeswoman for the Department of Insurance, said it's really "up to the federal government" to promote the exchange information. Still, she said, the agency expects to get phone calls and will be as helpful as possible. </p><p>"We're going to provide as much assistance as we can within our realm of authority and within the resources we have available," Hall said.</p><p><i>This report contains material from the Associated Press. </i></p><p>Metro desk: 343-2389</p><p>On <a href="http://www.starnewsonline.com/section/news41"><b>Twitter</b></a>: @StarNewsMolly</p><h3>By the numbers</h3>
<p><b>Uninsured:</b> According to U.S. <a href="http://www.starnewsonline.com/section/topic30"><b>Census</b></a> estimates for 2012 for counties with populations of at least 65,000:</p><p><b>In New Hanover County,</b> 31,084 (15.1 percent) of the total 206,497 population was uninsured. </p><p><b>In Brunswick County,</b> 18,025 (16.2 percent) of the total 111,087 population was uninsured.</p><p><b>Sneak peek:</b> The Kaiser Family Foundation provides an online calculator to estimate your insurance plan cost. Go to http://kff.org/interactive/subsidy-calculator/</p><p><b>Looking for help?</b></p><p>N.C. Insurance Advisors, a local insurance agency, is hosting a series of informational seminars in tandem with Blue Cross Blue Shield of North Carolina about the new federal health insurance program. The meetings, which are free, are aimed at both individuals and businesses.</p><p><b>Thursday:</b> 6-8 p.m. at the Small Business Center at <a href="http://www.starnewsonline.com/section/topic9937"><b>Cape Fear Community College</b></a>. Pre-register, which is required, at www.cfcc.edu/sbc. (Specifically for small businesses)</p><p><b>Oct. 8:</b> 10-11 a.m. at Northeast library, 1241 Military Cutoff Road.</p><p><b>Oct. 9:</b> 3-4 p.m. at Northeast library.</p><p><b>Oct. 15:</b> 10-11 a.m. at New Hanover County Cooperative Extension, 6206 Oleander Drive.</p><p><b>Oct. 26:</b> 10-11 a.m. at county Cooperative Extension.</p><p><b>Oct. 29:</b> 6:30-7:30 p.m. at county Cooperative Extension.</p>